Assisting cognitively impaired nursing home residents with bathing: Effects of two bathing interventions on caregiving
Assisting cognitively impaired nursing home residents with bathing: Effects of two bathing interventions on caregiving
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DOI：
10.1093/geront/46.4.524
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发表时间：
2006-08-01
期刊：
影响因子：
5.7
通讯作者：
Sloane, Philip D.
中科院分区：
文献类型：
--
作者：
Hoeffer, Beverly;Talerico, Karen Amann;Sloane, Philip D.
目的：当认知受损的养老院居民在洗澡时表现出激动和攻击性行为时，养老院护理人员处于一个独特的位置，以改善居民的体验。本报告讨论了接受以人为本的淋浴和毛巾浴方法培训的认证护理助理（CNA）是否表现出改善的洗澡行为（温柔和口头支持），并在帮助居民洗澡时经历了更大的准备（信心和轻松）和更少的痛苦（麻烦）。设计和方法：我们采用交叉设计，将15家疗养院随机分为两个治疗组和对照组，每组5家疗养院。在一个治疗组中，CNA接受以人为中心的训练，首先淋浴6周（时间1），然后毛巾浴6周（时间2）。我们颠倒了另一个治疗组的治疗顺序。对照组CNA使用常规淋浴程序，不进行以人为本的培训。我们在基线和时间1和时间2结束时收集了关于五个连续结局的观察和自我报告数据。我们分析了37个CNA协助69名居民的数据，采用3 × 2重复测量方差分析比较三组从基线的变化。结果如下：与对照组相比，治疗组在使用温柔和口头支持以及对轻松的感知方面有显着改善。影响：以人为本的淋浴和毛巾浴方法不仅改善了对洗澡时变得焦躁不安和咄咄逼人的居民的护理，而且改善了CNA在为这些居民洗澡时对他们的体验的看法。
Purpose: When cognitively impaired nursing home residents exhibit agitated and aggressive behaviors during bathing, nursing home caregivers are in a unique position to improve residents' experience. This report addresses whether certified nursing assistants (CNAs) who received training in a person-centered approach with showering and with the towel bath showed improved caregiving behaviors (gentleness and verbal support) and experienced greater preparedness (confidence and ease) and less distress (hassles) when assisting residents with bathing. Design and Methods: We used a crossover design and randomized 15 nursing homes into two treatment groups and a control group of 5 facilities each. In one treatment group, CNAs received personcentered training, first with showering for 6 weeks (Time 1) and then with the towel bath for 6 weeks (Time 2). We reversed the treatment order in the other treatment group. Control group CNAs used usual showering procedures without person-centered training. We collected observational and self-report data at baseline and at the end of Time 1 and Time 2 on five caregiving outcomes. We analyzed data from 37 CNAs assisting 69 residents by using 3 X 2 repeated measures analyses of variance to compare the three groups on change from baseline. Results: Compared with the control group, treatment groups significantly improved in the use of gentleness and verbal support and in the perception of ease. Implications: A person-centered approach with showering and with the towel bath improved not only how care is given to residents who become agitated and aggressive during bathing but also how CNAs perceive their experience when bathing these residents.